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Update 2016-2018 of the Nationwide Danish Fungaemia Surveillance Study: Epidemiologic Changes in a 15-Year Perspective

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Risum, Malene ; Astvad, Karen ; Johansen, Helle Krogh ; Schønheyder, Henrik Carl ; Rosenvinge, Flemming ; Knudsen, Jenny Dahl ; Hare, Rasmus Krøger ; Datcu, Raluca ; Røder, Bent Løwe ; Antsupova, Valeria Stanislavovna ; Kristensen, Lise ; Gertsen, Jan Berg ; Møller, Jens Kjølseth ; Dzajic, Esad ; Søndergaard, Turid Snekloth ; Arendrup, Maiken Cavling. / Update 2016-2018 of the Nationwide Danish Fungaemia Surveillance Study : Epidemiologic Changes in a 15-Year Perspective. I: Journal of fungi (Basel, Switzerland). 2021 ; Bind 7, Nr. 6. s. 1-16.

Bibtex

@article{6f71876eb7a344d3b616a7d7779edf6f,
title = "Update 2016-2018 of the Nationwide Danish Fungaemia Surveillance Study: Epidemiologic Changes in a 15-Year Perspective",
abstract = "As part of a national surveillance programme initiated in 2004, fungal blood isolates from 2016-2018 underwent species identification and EUCAST susceptibility testing. The epidemiology was described and compared to data from previous years. In 2016-2018, 1454 unique isolates were included. The fungaemia rate was 8.13/100,000 inhabitants compared to 8.64, 9.03, and 8.38 in 2004-2007, 2008-2011, and 2012-2015, respectively. Half of the cases (52.8%) involved patients 60-79 years old and the incidence was highest in males ≥70 years old. Candida albicans accounted for 42.1% of all isolates and Candida glabrata for 32.1%. C. albicans was more frequent in males (p = 0.03) and C. glabrata in females (p = 0.03). During the four periods, the proportion of C. albicans decreased (p < 0.001), and C. glabrata increased (p < 0.001). Consequently, fluconazole susceptibility gradually decreased from 68.5% to 59.0% (p < 0.001). Acquired fluconazole resistance was found in 4.6% Candida isolates in 2016-2018. Acquired echinocandin resistance increased during the four periods 0.0%, 0.6%, 1.7% to 1.5% (p < 0.0001). Sixteen echinocandin-resistant isolates from 2016-2018 harboured well-known FKS resistance-mutations and one echinocandin-resistant C. albicans had an FKS mutation outside the hotspot (P1354P/S) of unknown importance. In C. glabrata specifically, echinocandin resistance was detected in 12/460 (2.6%) in 2016-2018 whereas multidrug-class resistance was rare (1/460 isolates (0.2%)). Since the increase in incidence during 2004-2011, the incidence has stabilised. In contrast, the species distribution has changed gradually over the 15 years, with increased C. glabrata at the expense of C. albicans. The consequent decreased fluconazole susceptibility and the emergence of acquired echinocandin resistance complicates the management of fungaemia and calls for antifungal drug development.",
keywords = "Candida, candidaemia, candidiasis, resistance, echinocandin, mutation, epidemiology",
author = "Malene Risum and Karen Astvad and Johansen, {Helle Krogh} and Sch{\o}nheyder, {Henrik Carl} and Flemming Rosenvinge and Knudsen, {Jenny Dahl} and Hare, {Rasmus Kr{\o}ger} and Raluca Datcu and R{\o}der, {Bent L{\o}we} and Antsupova, {Valeria Stanislavovna} and Lise Kristensen and Gertsen, {Jan Berg} and M{\o}ller, {Jens Kj{\o}lseth} and Esad Dzajic and S{\o}ndergaard, {Turid Snekloth} and Arendrup, {Maiken Cavling}",
year = "2021",
month = jun,
day = "19",
doi = "10.3390/jof7060491",
language = "English",
volume = "7",
pages = "1--16",
journal = "Journal of Fungi",
issn = "2309-608X",
publisher = "MDPI AG",
number = "6",

}

RIS

TY - JOUR

T1 - Update 2016-2018 of the Nationwide Danish Fungaemia Surveillance Study

T2 - Epidemiologic Changes in a 15-Year Perspective

AU - Risum, Malene

AU - Astvad, Karen

AU - Johansen, Helle Krogh

AU - Schønheyder, Henrik Carl

AU - Rosenvinge, Flemming

AU - Knudsen, Jenny Dahl

AU - Hare, Rasmus Krøger

AU - Datcu, Raluca

AU - Røder, Bent Løwe

AU - Antsupova, Valeria Stanislavovna

AU - Kristensen, Lise

AU - Gertsen, Jan Berg

AU - Møller, Jens Kjølseth

AU - Dzajic, Esad

AU - Søndergaard, Turid Snekloth

AU - Arendrup, Maiken Cavling

PY - 2021/6/19

Y1 - 2021/6/19

N2 - As part of a national surveillance programme initiated in 2004, fungal blood isolates from 2016-2018 underwent species identification and EUCAST susceptibility testing. The epidemiology was described and compared to data from previous years. In 2016-2018, 1454 unique isolates were included. The fungaemia rate was 8.13/100,000 inhabitants compared to 8.64, 9.03, and 8.38 in 2004-2007, 2008-2011, and 2012-2015, respectively. Half of the cases (52.8%) involved patients 60-79 years old and the incidence was highest in males ≥70 years old. Candida albicans accounted for 42.1% of all isolates and Candida glabrata for 32.1%. C. albicans was more frequent in males (p = 0.03) and C. glabrata in females (p = 0.03). During the four periods, the proportion of C. albicans decreased (p < 0.001), and C. glabrata increased (p < 0.001). Consequently, fluconazole susceptibility gradually decreased from 68.5% to 59.0% (p < 0.001). Acquired fluconazole resistance was found in 4.6% Candida isolates in 2016-2018. Acquired echinocandin resistance increased during the four periods 0.0%, 0.6%, 1.7% to 1.5% (p < 0.0001). Sixteen echinocandin-resistant isolates from 2016-2018 harboured well-known FKS resistance-mutations and one echinocandin-resistant C. albicans had an FKS mutation outside the hotspot (P1354P/S) of unknown importance. In C. glabrata specifically, echinocandin resistance was detected in 12/460 (2.6%) in 2016-2018 whereas multidrug-class resistance was rare (1/460 isolates (0.2%)). Since the increase in incidence during 2004-2011, the incidence has stabilised. In contrast, the species distribution has changed gradually over the 15 years, with increased C. glabrata at the expense of C. albicans. The consequent decreased fluconazole susceptibility and the emergence of acquired echinocandin resistance complicates the management of fungaemia and calls for antifungal drug development.

AB - As part of a national surveillance programme initiated in 2004, fungal blood isolates from 2016-2018 underwent species identification and EUCAST susceptibility testing. The epidemiology was described and compared to data from previous years. In 2016-2018, 1454 unique isolates were included. The fungaemia rate was 8.13/100,000 inhabitants compared to 8.64, 9.03, and 8.38 in 2004-2007, 2008-2011, and 2012-2015, respectively. Half of the cases (52.8%) involved patients 60-79 years old and the incidence was highest in males ≥70 years old. Candida albicans accounted for 42.1% of all isolates and Candida glabrata for 32.1%. C. albicans was more frequent in males (p = 0.03) and C. glabrata in females (p = 0.03). During the four periods, the proportion of C. albicans decreased (p < 0.001), and C. glabrata increased (p < 0.001). Consequently, fluconazole susceptibility gradually decreased from 68.5% to 59.0% (p < 0.001). Acquired fluconazole resistance was found in 4.6% Candida isolates in 2016-2018. Acquired echinocandin resistance increased during the four periods 0.0%, 0.6%, 1.7% to 1.5% (p < 0.0001). Sixteen echinocandin-resistant isolates from 2016-2018 harboured well-known FKS resistance-mutations and one echinocandin-resistant C. albicans had an FKS mutation outside the hotspot (P1354P/S) of unknown importance. In C. glabrata specifically, echinocandin resistance was detected in 12/460 (2.6%) in 2016-2018 whereas multidrug-class resistance was rare (1/460 isolates (0.2%)). Since the increase in incidence during 2004-2011, the incidence has stabilised. In contrast, the species distribution has changed gradually over the 15 years, with increased C. glabrata at the expense of C. albicans. The consequent decreased fluconazole susceptibility and the emergence of acquired echinocandin resistance complicates the management of fungaemia and calls for antifungal drug development.

KW - Candida

KW - candidaemia

KW - candidiasis

KW - resistance

KW - echinocandin

KW - mutation

KW - epidemiology

U2 - 10.3390/jof7060491

DO - 10.3390/jof7060491

M3 - Journal article

C2 - 34205349

VL - 7

SP - 1

EP - 16

JO - Journal of Fungi

JF - Journal of Fungi

SN - 2309-608X

IS - 6

M1 - 491

ER -

ID: 66573070